adult education interim approval form
TRANSCRIPT
The purpose of an interim course approval is to allow a student to enroll pending receipt of an official approval signed by a high school guidance counselor or school official. The parent or guardian may elect to register their student for the courses indicated below without an official approval, but in doing so, thereby releases HCC of any liability for courses taken that are not accepted by the student’s school. Failure to provide the official approval by the second week of classes will preclude any schedule change or refund.
STUDENT NAME
HCC ID NUMBER
HOME TELEPHONE
STUDENT’S MAILING ADDRESS
HIGH SCHOOL NAME AND ADDRESS
I understand that refunds are authorized only if HCCS cancels the class. Prior to registration all students must sign below indicating they understand and accept this policy. Are you currently attending high school? Yes; No. Are you an athlete who will be applying to a Division I or II college or university? Yes; No
STUDENT SIGNATURE DATE
FAX APPROVAL TO 713.718.7708 OR EMAIL TO [email protected]
TO BE COMPLETED BY ADULT STUDENT, PARENT, OR LEGAL GUARDIAN PARENT/LEGAL GUARDIAN’S PRINTED NAME
HOME PHONE
MOBILE PHONE
PARENT/LEGAL GUARDIAN’S E-MAIL ADDRESS
Parent/Legal Guardian’s Signature (Student must be 18 yrs old to authorize enrollment without parental consent.)
COURSE TITLE MEETING TIME LOCATION PRICE PER CLASS TOTAL
EXAMPLES ENGLISH 3A ALGEBRA 1B
SSU 1-4 MON/WED
PINEMONT WLGAYHALL $175 175
175
$175 $175 $175
HOW MANY CLASSES FROM ABOVE ARE ART, BCIS, OR BIM CLASSES? X $10 = TOTAL FOR THIS SEMESTER
POLICIES ON ATTENDANCE, DISCIPLINE, AND STUDENT CONDUCT; & A STATEMENT ON DISABILITY SERVICES Students are expected to attend all classes regularly. Class attendance is the responsibility of the student, and the student should consult the instructor for make-up assignments after an absence has occurred. On the fifth (5th) hour of absence, the student is automatically dropped from the course. Complete cooperation is essential. Failure to maintain good self-discipline will result in dismissal from class with a failing grade. Prior to FIRST DAY of class contact AHS either by phone 713.718.7611 or email [email protected] to officially DROP a class. Student Policies on Discipline and Student Conduct are contained in the Student Handbook located at this website http://www.hccs.edu/hcc/System%20Home/Departments/Student_Handbook/student_policies.pdf. Any student with a documented disability (e.g. physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the Disability Services Office at the respective college at the beginning of each semester. Faculty is authorized to provide only the accommodations requested by the Disability Support Services Office. If you have any questions, please contact the disability counselor at your college or Donna Price at 713.718.5165.
PLEASE CALL 713/718-7611 FOR COURSES NOT LISTED AND FOR REGISTRATION INFORMATION. ACTING CHANCELLOR—Renee Smith Byas. BOARD OF TRUSTEES— Bruce A. Austin, Sandie Mullins, Eva Loredo, Yolanda Navarro Flores, Herlinda Garcia, Carroll G. Robinson, Leila Feldman, Neeta Sane, Christopher W. Oliver Houston Community College System seeks to provide equal educational opportunities without regard to race, color, religion, national origin, sex, age, or disability. Please visit the Houston Community College web site, www.hccs.edu, for the latest schedule and information regarding courses offered at other HCC-Adult High School campuses. HCC makes no guarantees as to the accuracy or quality of information contained in this publication, including but not limited to, the availability of courses. All information contained herein is subject to change without notice. 6133Interim:4/24/13
INTERIM COURSE APPROVAL